Gonorrhea: Neisseria gonorrhoeae "gonococcus"

Is Neisseria gonorrhoeae gram - or gram +?

Gram -

What shape is Neisseria gonorrhoeae?

diplococcus

Is Neisseria gonorrhoeae anaerobic or aerobic?

obligate aerobe (like N. meningitidis)

Is Neisseria gonorrhoeae motile or non-motile?

non-motile

What is the reservoir for Neisseria gonorrhoeae?

humans

How is Neisseria gonorrhoeae transmitted?

unprotected sex (veginal, oral, anal)

What disease does Neisseria gonorrhoeae cause?

Gonorrhea; pelvic inflammatory disease (PID)

Urethritis (urethra inflammation)

Conjunctivitis: newborn blindness

• rapid corneal scarring (24-48h)

• medical emergency

Pelvic inflammatory disease (PID)

• scarring of fallopian tubes

• infertility

What are newborns given within one hour of birth to prevent conjunctivitis

Newborns get erythromycin ointment in eye.

What are the main symptoms of gonorrhea?

pain during urination, genital discharge, vaginal bleeding

What is the pathogenesis for Gonococcus?

Adherence to epithelial cell surface

• type IV pili, Opacity (Opa) proteins

• type IV pili form microcolonies on epithelial cell surface

Invades the epithelium

• can infect other mucosal sites like the rectum, pharynx, and conjunctiva (eyes)

Stimulates inflammatory response

• recruits and activates neutrophils which damages the epithelium

What are the consequences for women from gonococcal disease?

• PID: damage/ scarring to fallopian tubes

  • infertility, shock if tubes ruptured

• infant blindness (infect eye in birth canal)

• chronic pelvic pain

What are the consequences for men from gonococcal disease?

• infection of epididymis (tube that carries sperm away from testis); infertility

What are the main gonococcal virulence factors?

• Type IV pili: attach to mucosal surface

• Opa: bind and invade epithelial and endothelial cells’

• LOS: inflammation/ tissue damage; resist AMPs

• sIgA protease (in urinary tract) → cleaves sIgA

Why is Neisseria gonorrhoeae nicknamed a “shapeshifter”

• phase variation: Pili and opa (On to Off)

• antigenic variation: different pili and opa proteins

What is the main treatment for N. gonorrhoeae?

Antibiotics, but they are mostly abx resistant. CDC labels it as an “urgent threat” pathogen.